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Global Journal of Transfusion Medicine
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Open Access journal
ISSN (Print) 2468-8398 - ISSN (Online) 2455-8893
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Donor confidentiality and privacy: Need of the hour in this era of
digitalization
- Authors: Shivaram Chandrashekar
  Pages: 1 - 3
  Abstract: Shivaram Chandrashekar
  Global Journal of Transfusion Medicine 2023 8(1):1-3
  
  Citation: Global Journal of Transfusion Medicine 2023 8(1):1-3
  PubDate: Fri,12 May 2023
  DOI: 10.4103/2468-8398.376689
  Issue No: Vol. 8, No. 1 (2023)
Low-titer O whole blood in management of massive bleeding
- Authors: Sangeeta Pahuja
  Pages: 4 - 9
  Abstract: Sangeeta Pahuja
  Global Journal of Transfusion Medicine 2023 8(1):4-9
  The management of massively bleeding patients has undergone paradigm shift. With the evolution of bundle of care in form of damage control resuscitation, early blood-based resuscitation has emerged as one of the pillars of treatment; focused at preventing shock, coagulopathy, and thrombocytopenia. Military has always relied on low-titer O whole blood (LTOWB) to provide balanced hemostatic resuscitation for bleeding patients in combat casualties. Good results from military practice have led to questioning of practices followed in civilian bleeding trauma patients. With the realization that cold-stored platelets are functionally superior for immediate hemostasis, there is renewed interest in role of LTOWB in providing early hemostatic resuscitation to massively bleeding patients. Not only does LTOWB provide all the components but it also has an advantage of simplifying resuscitation logistics by providing all the components in one bag instead of three, in situations where delay of every minute leads to increased mortality. It can provide blood-based resuscitation in scenarios where it may not otherwise be possible. It can be used across all blood groups. This review explores the concerns regarding the use of LTOWB, historical perspective, advantages, and disadvantages. Several studies have shown that LTOWB is noninferior, as compared to components, and is a safe practice, without significant transfusion-related adverse events. The use of LTOWB in bleeding patients needs further studies to explore its efficacy and safety versus component therapy.
  Citation: Global Journal of Transfusion Medicine 2023 8(1):4-9
  PubDate: Fri,12 May 2023
  DOI: 10.4103/gjtm.gjtm_38_22
  Issue No: Vol. 8, No. 1 (2023)
Paid plasma versus voluntary nonremunerated plasma collection for
plasma-derived medicine: Iran experience with a short glance at a few
countries
- Authors: Ali Akbar Pourfathollah, K Shamsasenjan, M Hadipour Dehshal
  Pages: 10 - 16
  Abstract: Ali Akbar Pourfathollah, K Shamsasenjan, M Hadipour Dehshal
  Global Journal of Transfusion Medicine 2023 8(1):10-16
  Iranian Blood Transfusion Organization (IBTO) established in 1975 has been the sole responsible entity for blood adequacy and safety in Iran. It has been the same in case of providing recovered plasma. At the same time, the first commercial plasma center was authorized by IBTO to operate in the capital Tehran to contribute to the main purpose that was the investment of the private sector in fulfilling fractionation purposes and the construction of a fractionation plant. The goal that unfortunately did not materialize. To make remedies based on a well-calculated plasma document, in 2015, a plasma program developed in Iran by IBTO by which new donor centers were opened or already blood center were equipped to allow for the collection of voluntary nonremunerated source plasma. It had in it capacities of plasma collection for IBTO recovered, commercial source, and IBTO voluntary source. The latter third was a gradually growing program that lasted just 3 years and showed progress but the managerial changes and invalid arbitrary and sudden decisions brought it to the end. Whilst the paid private centers grew and ruined the voluntary nonremunerated sense that IBTO always pursued and was against the Ministry of Health requirements for what the commercial private sectors should have abided by. Safe voluntary nonremunerated source plasma collection that almost all countries pursue to grow along with existing recovered plasma share was terminated with consequences that are detailed in the present article.
  Citation: Global Journal of Transfusion Medicine 2023 8(1):10-16
  PubDate: Fri,12 May 2023
  DOI: 10.4103/gjtm.gjtm_88_22
  Issue No: Vol. 8, No. 1 (2023)
A knowledge, attitudes, and practices survey concerning blood donation
among Libyans
- Authors: AJ Goldsmith, NM Gebril, D Sondag Thull, YE Abdella, L Barski, PY Malgor, F Bossolini, O Aldaher, Cees Theodoor Smit Sibinga
  Pages: 17 - 22
  Abstract: AJ Goldsmith, NM Gebril, D Sondag Thull, YE Abdella, L Barski, PY Malgor, F Bossolini, O Aldaher, Cees Theodoor Smit Sibinga
  Global Journal of Transfusion Medicine 2023 8(1):17-22
  Background and Objectives: Libya's blood transfusion system suffers from chronic blood shortages due to low rates of voluntary, nonremunerated blood donors (VNRBDs). Over 90% of blood donations are for family members or friends of donors, and only 1% of donors are women. This study aimed to understand the barriers and motivations for blood donation in Libya to support sensitization campaigns. Methods: A knowledge, attitudes, and practices survey was conducted with 896 people in seven Libyan cities where blood banks are located. Key informant interviews were conducted with blood donors, staff, and experts across all seven cities. Thematic content analysis was conducted for the qualitative data, and SPSS was used to produce descriptive statistics. Results: There was a strong awareness of blood donation and the uses of donated blood within the surveyed population. Most respondents who had not donated blood had considered donating. The association between blood donation and Hijama, the traditional medical bloodletting practice, was cited as a sensitization experience for some VNRBDs. The common barriers for potential female donors included misconceptions about female eligibility, social norms, and constraints based on the opinions of their husbands. Conclusion: Sensitization campaigns can encourage people to donate for the first time to dispel fears and reinforce the connection between blood donation and altruistic/religious giving. Religious institutions, including mosques and Hijama centers, must be engaged to emphasize that blood donation is ethically compatible with Islam. Campaigns should also highlight that women are eligible to donate blood.
  Citation: Global Journal of Transfusion Medicine 2023 8(1):17-22
  PubDate: Fri,12 May 2023
  DOI: 10.4103/gjtm.gjtm_78_22
  Issue No: Vol. 8, No. 1 (2023)
A prospective study on the prevalence of red cell alloimmunization via
fetomaternal hemorrhage and its association with bad obstetric history
- Authors: Divya Vijayakumar, PS Shaiji, D Meena, Soonam John
  Pages: 23 - 27
  Abstract: Divya Vijayakumar, PS Shaiji, D Meena, Soonam John
  Global Journal of Transfusion Medicine 2023 8(1):23-27
  Background and Objectives: The presence of irregular red cell antibodies in the serum of pregnant women is named maternal alloimmunization. Sensitizing events such as traumatic delivery and miscarriage can cause fetomaternal hemorrhage, increasing the risk of alloimmunization. Our objective was to estimate the prevalence of red cell alloantibodies among multigravidae and to study its association with those cases with bad obstetric history (BOH). Methods: This was a 1-year cross-sectional study done on 900 multigravidae in the Department of Transfusion Medicine, Medical College, Thiruvananthapuram. We excluded patients with a history of blood transfusion. Results: Out of 900 subjects, 49 (5.4%) were alloimmunized. The RhD-positive cases were predominant (77.4%), while 203 (22.6%) were RhD negative. Among the D-positive women, the prevalence of alloimmunization was 1.3%. The most frequent alloantibody identified was anti-D, followed by anti-G (18.4%). The alloantibodies identified among RhD-positive were anti-E, anti-c, anti-C, anti-Fya, anti-M, anti-Jka, and anti-Leb. We identified a total of 58 clinically significant alloantibodies. Thus, Rh blood group alloantibodies constitute 93.1% and the remaining 6.9% by other blood groups. Out of 159 cases with BOH, 17 were alloimmunized, and there was a statistically significant association between them (P = 0.001). Conclusion: Alloantibodies potentially causing hemolytic disease of the fetus and newborn were found in D-negative (19.7%) and D-positive (1.3%) mothers. The clinicians should change the current practice of screening only D-negative pregnant women, and antibody screening should be offered to all females or at least those with BOH. We may thus ensure early detection and periodic monitoring of all alloimmunized women.
  Citation: Global Journal of Transfusion Medicine 2023 8(1):23-27
  PubDate: Fri,12 May 2023
  DOI: 10.4103/gjtm.gjtm_75_22
  Issue No: Vol. 8, No. 1 (2023)
A survey of Chinese regular blood donors who were enrolled into an iron
replenishment program – A hint for dietary factors
- Authors: Idy Yik Mun LEE, Chelly Chui Yee CHU, Nga Sze WONG, Lai Yi LEUNG, Cheuk Kwong LEE
  Pages: 28 - 33
  Abstract: Idy Yik Mun LEE, Chelly Chui Yee CHU, Nga Sze WONG, Lai Yi LEUNG, Cheuk Kwong LEE
  Global Journal of Transfusion Medicine 2023 8(1):28-33
  Background and Objectives: Concern on donors' health and safety is growing in importance in many countries. One of the key issues is related to low body iron store in regular blood donors that some countries have advocated iron supplementation in addition to education. A survey was performed to look at the dietary factors in blood donors under an iron replenishment program in Hong Kong. The objectives of this survey were to evaluate the possible causes for iron deficiency and evaluate the effectiveness of education and iron supplementation program. Methods: A pre- and post- health education survey was conducted to evaluate the effectiveness of an iron replenishment program addressing iron deficiency among regular blood donors. Eligible donors were invited to attend a health education held by a registered nurse after predonation hemoglobin test. A questionnaire was used to ask donors on their dietary habit, knowledge on iron deficiency, and iron supplement. Results: Of 428 participants, male donors preferred eating out for breakfast (P = 0.003) and lunch (P = 0.0005) than females. Those donors who preferred eating out were also likely to have higher frequency of taking tea or coffee (P = 0.0005). When compared the donors' knowledge and confident level in taking iron replacement, significance was identified between genders and pre- and posthealth education. An affirmative donor satisfaction toward the nursing support and the iron replenishment program was also observed. Conclusion: The study result provided an insight into the possible dietary factors. The positive outcome of the health education warrants further planning of educational strategies to address the gender difference but also to achieve a better effect from iron replenishment.
  Citation: Global Journal of Transfusion Medicine 2023 8(1):28-33
  PubDate: Fri,12 May 2023
  DOI: 10.4103/gjtm.gjtm_15_22
  Issue No: Vol. 8, No. 1 (2023)
Evaluation of appropriateness of red blood cell transfusions: A
prospective audit at a tertiary care oncology centre
- Authors: Priti Desai, Anisha Navkudkar, Nileema More, Sunil B Rajadhyaksha
  Pages: 34 - 39
  Abstract: Priti Desai, Anisha Navkudkar, Nileema More, Sunil B Rajadhyaksha
  Global Journal of Transfusion Medicine 2023 8(1):34-39
  Background and Objectives: Red blood cells (RBC) transfusion is an important medical therapy in modern medicine. Blood is a scarce resource used in large numbers; therefore, it is very essential for its components to be used appropriately and judiciously. It is necessary to monitor, assess, and evaluate the existing trends and appropriateness of blood utilization. The establishment of criteria for blood transfusion and strict adherence to such criteria may be necessary to improve blood usage. The objective of this study was to understand the utilization pattern of RBC transfusions based on indications and to evaluate the appropriateness of RBC transfusion at a tertiary care oncology center. Methods: This was a prospective observational study conducted over a period of 4 months. A total of 4413 RBC transfusion events in 2012 adult oncology patients were analyzed for appropriateness as per institutional guidelines. Data were obtained from the blood requisitions, issue records of the Department of Transfusion Medicine and from the Electronic Medical Records of the patients. Results: Total of 83% of transfusion events were found to be appropriate with Anemia being the most common indication for RBC transfusion in medical and surgical oncology units. Appropriateness was significant (P < 0.05) in medical oncology as compared to surgical oncology units. Appropriateness was highest and statistically significant (P < 0.05) in operation theatres while inappropriateness was more and significant in the daycare facility (P < 0.05). Conclusion: Total 83% of RBC transfusions were found to be appropriate indicating that clinical practices of RBC transfusions in the hospital were rational with adherence to institutional guidelines.
  Citation: Global Journal of Transfusion Medicine 2023 8(1):34-39
  PubDate: Fri,12 May 2023
  DOI: 10.4103/gjtm.gjtm_100_21
  Issue No: Vol. 8, No. 1 (2023)
Analysis of blood collection of national blood transfusion service, Sri
Lanka: A time series analysis
- Authors: Samantha Kumara Senavirathna, Nishanthi Rupika Abeynayake
  Pages: 40 - 45
  Abstract: Samantha Kumara Senavirathna, Nishanthi Rupika Abeynayake
  Global Journal of Transfusion Medicine 2023 8(1):40-45
  Background and Objectives: Blood transfusion is a widely accepted treatment modality in modern medical practice and it has no substitute. Therefore, blood is a scarce resource, and proper management of bloodstock is essential. Transfusion service is responsible to maintain an adequate blood stock to ensure the supply of blood for hospitals while minimizing blood wastage due to postexpiry. To achieve efficient bloodstock management, the pattern of blood collection should be identified. This study was designed to establish a time series model for monthly blood collection of Sri Lanka. Methods: Data on monthly blood collection of Sri Lanka were collected from the year 2010 to 2020 and time series models were developed using “R” statistical software. Results: Time series data clearly exhibited an increasing trend with seasonality in blood collection. Therefore, seasonal time series models were fitted and the best seasonal autoregressive integrated moving average (ARIMA) model was selected as ARIMA (0, 1, 1) (0, 1, 2) (12) which showed the lowest Akaike information criteria value. Conclusion: It is suitable for forecasting the monthly blood collection.
  Citation: Global Journal of Transfusion Medicine 2023 8(1):40-45
  PubDate: Fri,12 May 2023
  DOI: 10.4103/gjtm.gjtm_92_22
  Issue No: Vol. 8, No. 1 (2023)
Assessment of quality management practices across Asian countries
- Authors: Sadhana Mangwana, Nidhi Bhatnagar, L Aravinth, Nabajyoti Choudhury
  Pages: 46 - 50
  Abstract: Sadhana Mangwana, Nidhi Bhatnagar, L Aravinth, Nabajyoti Choudhury
  Global Journal of Transfusion Medicine 2023 8(1):46-50
  Background and Objectives: Globally, there is a wide variation in Quality management practices and availability of Quality Standards. Because of a paucity of data on QM practices in BTS in various Asian countries, this study was undertaken to understand the quality assurance (QA) programme within the blood bank settings. Methods: The study was conducted by the Quality Working Group of Asian Association of Transfusion Medicine (AATM), by an online questionnaire having 25 questions which were circulated amongst various blood centres of member Countries of Asian Association of Transfusion Medicine (AATM). Results: 60 blood centres participated. 43 were Hospital based Blood Centres and 17 were from Stand-alone Blood Centres. The majority of the responders were from a tertiary care hospital (92%). More than 83% of blood centres, either accredited or planning to move forward, were conducting internal audits, more than 86% were having Quality policy and QMS. Conclusion: It is evident from this study that blood centres, by and large, maintain good practices as they are under the purview of regulatory bodies of the respective countries and hence follow Good Manufacturing Practices (GMP). As the Asian countries come under the LMIC category; hence the financial cost could be a major hindrance in achieving quality standards, but few extra miles to achieve quality standards or accreditation will ultimately lead to better patient care.
  Citation: Global Journal of Transfusion Medicine 2023 8(1):46-50
  PubDate: Fri,12 May 2023
  DOI: 10.4103/gjtm.gjtm_73_22
  Issue No: Vol. 8, No. 1 (2023)
A cross-sectional study on immunoglobulin G serology against severe acute
respiratory syndrome coronavirus 2 among health-care workers and blood
donors in an oncology center in Eastern India along with an assessment of
their knowledge, attitude, and practice toward blood donation during
COVID-19
- Authors: Nasir Nabi Naikoo, Sabita Basu, Sanjay Bhattacharya, Gaurav Goel, Soumyadip Chatterji, Suvro Sankha Datta
  Pages: 51 - 56
  Abstract: Nasir Nabi Naikoo, Sabita Basu, Sanjay Bhattacharya, Gaurav Goel, Soumyadip Chatterji, Suvro Sankha Datta
  Global Journal of Transfusion Medicine 2023 8(1):51-56
  Background and Objectives: The objective of this study was to determine the presence of immunoglobulin G (IgG) antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in prevaccinated health-care workers (HCWs) and blood donors among different categories (categories A to D) based on their previous SARS-CoV-2 infection status along with a knowledge, attitude, and practice (KAP) assessment to understand the impact of coronavirus disease 2019 (COVID-19) on blood transfusion services and to determine their willingness to donate COVID convalescent plasma (CCP). In addition to that, we studied a small cohort of postvaccinated HCWs and blood donors for IgG antibodies to observe the humoral response after COVID-19 vaccination. Methods: This was a cross-sectional, observational, study done in India during the first and second waves of the COVID-19 pandemic. A total of 315 prevaccinated individuals were tested for SARS-CoV-2 IgG antibody to the spike protein using SARS-CoV-2-IgG antibody kits by chemiluminescence immunoassay. Among them, 134 were blood donors and 181 were HCWs. The postvaccinated cohort consisted of 36 HCWs and 21 blood donors. Results: About 90.56% of donors in category A (blood donors with a history of COVID-19) and 22.22% of donors in category B (blood donors without a history of COVID-19) had IgG antibodies to SARS-CoV-2. In category C (HCWs who had a history of COVID-19), an inverse relationship was observed between the reverse transcription–polymerase chain reaction cycle threshold average and the IgG value. Overall, the seroprevalence was more in blood donors compared to the HCWs. The seroconversion rate was 92.9% in the postvaccinated cohort. A positive intent was observed in 64% of donors during the KAP assessment regarding CCP donation. Conclusion: This study throws light on the herd immunity status of the Indian population which could further assist in prioritizing the vaccination programs to high-risk individuals. The KAP studies highlight the need for more awareness programs on blood donation during COVID-19.
  Citation: Global Journal of Transfusion Medicine 2023 8(1):51-56
  PubDate: Fri,12 May 2023
  DOI: 10.4103/gjtm.gjtm_36_22
  Issue No: Vol. 8, No. 1 (2023)
Analysis of key indicators of research, development, and innovation in
blood establishments and their impact on the delivery of improved quality
health products and services
- Authors: Geethika Sajeewani Manchanayake, Joan García-López, Joaquim Vives
  Pages: 57 - 61
  Abstract: Geethika Sajeewani Manchanayake, Joan García-López, Joaquim Vives
  Global Journal of Transfusion Medicine 2023 8(1):57-61
  Background and Objectives: The contribution of blood establishments (BEs) on Research, Development, and Innovation (R + D + I) is minimally addressed in the literature. Herein, we present an analysis of key indicators of R + D + I in BEs and discuss the impact of their R + D + I interests and priority areas, resources, and outcomes on the delivery of quality health products and services. Methods: Data from a worldwide representation of BEs were collected and analyzed in 2020. We assessed R + D + I areas studied, budget allocations, collaborations with other institutes, number of research staff available, and scientific production of BEs. Results: Details of 15 BEs from four continents were included in the study. All of them conducted R + D + I on a better understanding of their products and product safety. Other areas focused on were donors and donations (87%), bone marrow transplantation (80%), transfusion practices (80%), and immunogenetics (80%). 1%–11% (median of two points five %) of staff and 35–238 (median of 70, n = seven) in number, were involved in R + D + I. In 2018–2019, the budget allocated for R + D + I varied from € two point 6 to €13.7 million (median €seven point 6 million, n = 8) and it was zero point eight–10.5% (median of two points one %) of the total budget of BEs. Twelve (80%) and 11 (73%) BEs collaborated with academic institutes and hospitals, respectively. All centers generated publications and conference presentations, whereas only 4 (27%) hold patents. Conclusion: Research is an essential component in BEs that further potentiates R + D + I by partnering with research centers and universities as well as establishing specialized networks. A strong commitment to allocate resources and establish dedicated facilities or strategic alliances may generate world-class innovations in this ever-growing field.
  Citation: Global Journal of Transfusion Medicine 2023 8(1):57-61
  PubDate: Fri,12 May 2023
  DOI: 10.4103/gjtm.gjtm_48_22
  Issue No: Vol. 8, No. 1 (2023)
Transitory absence of ABO antibodies during severe acute respiratory
syndrome coronavirus 2 infection
- Authors: Soumya Das, Manisha Karaskar, Sandeep B Dabhekar, Rajashree Khot, Kiran Kumar Prathipati, Vijay G Bidkar, BH Shrikrishna, Sunita Kumbhalkar
  Pages: 62 - 64
  Abstract: Soumya Das, Manisha Karaskar, Sandeep B Dabhekar, Rajashree Khot, Kiran Kumar Prathipati, Vijay G Bidkar, BH Shrikrishna, Sunita Kumbhalkar
  Global Journal of Transfusion Medicine 2023 8(1):62-64
  Since the advent of the pandemic, ABO blood group has a role in the immunopathogenesis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Disagreement between forward and reverse typing leads to ABO discrepancy which arise either due to intrinsic problems or from the technical errors in performing the test. Here, we document the two cases of transient absence anti-A and anti-B antibodies among two COVID patients proved by serological techniques, with the photographic representation of their immunohematological workups. SARS-CoV-2 viral envelop proteins mimicking as A and B antigen expressed on red blood cells (ABOs) and anti-A and anti-B antibodies acting as viral neutralizing antibodies, possible explanation for appearance of such phenomenon among patients. The ABO blood grouping of such discrepancy patients should be cautiously reported and advised to repeat once after full recovery. Transfusion center should be prepared appropriately in case of blood component support needed among such patients.
  Citation: Global Journal of Transfusion Medicine 2023 8(1):62-64
  PubDate: Fri,12 May 2023
  DOI: 10.4103/gjtm.gjtm_95_22
  Issue No: Vol. 8, No. 1 (2023)
Immunohematology red cell serology testing reference laboratory: An
experience from a tertiary health-care center in India
- Authors: Prashant Pandey, Supriya Kumari, Divya Setya, Saikat Mandal, Arghyadeep Marik, Mukesh Kumar Singh
  Pages: 65 - 70
  Abstract: Prashant Pandey, Supriya Kumari, Divya Setya, Saikat Mandal, Arghyadeep Marik, Mukesh Kumar Singh
  Global Journal of Transfusion Medicine 2023 8(1):65-70
  Immunohematology reference laboratory (IRL) is defined as a fully equipped advanced laboratory that receives samples from various parts of the country for workup. This is a specialized center, where other centers experiencing difficulty in resolving immunohematological tests, refer samples for further workup and resolution. To complete the workup process, ABO RhD typing, antibody screening, identification (ID), antigen phenotyping, and direct antiglobulin tests are performed. In our retrospective observational study 528 cases, worked up from October 2019 to March 2022 were included. The prevalence of alloimmunization found in this evaluation was 68.1%. Among the different alloantibodies, anti-D was most common followed by anti-E and anti-M. In our study, most of the autoantibodies were of Immunoglobulin G (IgG) class (79.31%). Out of the 528 samples, ABO discrepancy was found in 48 samples (9%). Of these, none belonged to Group I or Group III discrepancy types. Group II discrepancies were noted in 28 cases (58.3%) and Group IV discrepancies were found in 20 cases (41.6%). Our study clearly indicates that there is an important role of IRL which is not only limited to ID of alloantibodies or resolution of ABO discrepancies but also supports all the hospitals and transfusion centers in the region by providing phenotype-matched or compatible units and advice for safe transfusion practices.
  Citation: Global Journal of Transfusion Medicine 2023 8(1):65-70
  PubDate: Fri,12 May 2023
  DOI: 10.4103/gjtm.gjtm_85_22
  Issue No: Vol. 8, No. 1 (2023)
Dual red cell alloimmunization with anti-c and anti-E antibodies: A
systematic approach to workup and transfusion management in different
clinical scenarios in resource-limited settings
- Authors: Sangeeta Pahuja, Richa Chauhan, Geetika Sharma, Deeksha Singh, Manisha Singh, Ram Vilash Yadav
  Pages: 71 - 78
  Abstract: Sangeeta Pahuja, Richa Chauhan, Geetika Sharma, Deeksha Singh, Manisha Singh, Ram Vilash Yadav
  Global Journal of Transfusion Medicine 2023 8(1):71-78
  Background and Objectives: Alloimmunization can lead to difficulty in arranging compatible, antigen-negative blood units for the patients. Alloimmunization by coexisting “c” and “E” antibodies, though common, is frequently missed. Both “c” and “E” antigens are highly immunogenic and have the potential to cause hemolytic disease of newborn and hemolytic transfusion reactions. The objective of this study is to discuss different clinical scenarios of concomitant and singular presence of anti-c and anti-E along with the diagnostic approach and transfusion management in resource-limited settings. Methods: Column agglutination gel technology in low ionic strength solution phase was used for initial antibody identification. Detailed immunohematological workup was done by the use of select cells (c+, E− and c−, E+) and adsorption elution studies using a commercially available acid elution kit. Results: Out of 16 patients, detailed immunohematological workup was available for 14 patients, whereas two patients were lost to follow-up. Among 14 patients, 12 had CCDee (R1R1) phenotype, whereas two patients had CcDee phenotype (possible R1r) with anti-E antibody. In 12 patients with R1R1 phenotype, 6/12 (50%) had dual coexisting anti-c and E, whereas 3/12 (25%) had only anti-c and 3/12 (25%) had only anti-E. In R1R1 patients having anti-E, coexisting anti-c was found in 6/9 (66.66%) of patients. Conclusion: The study emphasizes the use of both “c” and “E” negative red cells (R1R1) in R1R1 patients having either anti-c or anti-E. Thus, in India, there is a need to develop our own red cell panels having an adequate representation of indigenous antigens and phenotypes.
  Citation: Global Journal of Transfusion Medicine 2023 8(1):71-78
  PubDate: Fri,12 May 2023
  DOI: 10.4103/gjtm.gjtm_29_22
  Issue No: Vol. 8, No. 1 (2023)
A rare case of Bm (Bweak) phenotype detected in a healthy blood donor from
Eastern India
- Authors: Mahua Reddy, Sabita Basu, Debapriya Basu, Suvro Sankha Datta
  Pages: 79 - 81
  Abstract: Mahua Reddy, Sabita Basu, Debapriya Basu, Suvro Sankha Datta
  Global Journal of Transfusion Medicine 2023 8(1):79-81
  A 52-year-old male repeats voluntary blood donor donated at our blood center for the first time. Historical blood group was O, Rh (D) positive. Initial blood grouping was done on the fully automated immunohematology analyzer using column agglutination technique (CAT). Discrepant results (forward as group O and reverse as group B) were observed while performing the ABO blood grouping by CAT. Repeat testing by conventional tube technique showed the same discrepancy. Antibody detection test and direct antiglobulin test results were negative. After adsorption-elution, the eluate reacted only with group B red cells. Saliva testing for secretor status shows the presence of B and H substances. Finally, it was classified as a case of Bm (now called Bweak) phenotype. As a precautionary measure, the donor was recalled and a special blood group card was issued with a clear mention of his respective donor and recipient status. This case showed the importance of ABO subgroup determination that can help blood centers to establish defined transfusion protocol and prepare an elaborate rare blood donor registry.
  Citation: Global Journal of Transfusion Medicine 2023 8(1):79-81
  PubDate: Fri,12 May 2023
  DOI: 10.4103/gjtm.gjtm_53_22
  Issue No: Vol. 8, No. 1 (2023)
R2R2 phenotype blood requirements for liver transplantation surgery in a
child with multiple Rh antibodies: Meeting needs and changing Indian
scenario
- Authors: Deepti Sachan, Deepthi Krishna Gundrajukuppam, Naresh Shanmugam, Rajesh Rajalingam, Mohamed Rela
  Pages: 82 - 85
  Abstract: Deepti Sachan, Deepthi Krishna Gundrajukuppam, Naresh Shanmugam, Rajesh Rajalingam, Mohamed Rela
  Global Journal of Transfusion Medicine 2023 8(1):82-85
  Red cell alloimmunization often poses challenge for transfusion support during surgery. As transfusion needs are unpredictable in liver transplant recipients, it requires well-equipped immunohematology laboratory for timely antibody identification and good coordination with other blood centers, for the arrangement of compatible units in case of rare phenotypes. We present a case of child with multiple Rh antibodies (Anti-C & anti-e) requiring rare R2R2 phenotype blood units for liver transplantation. With no antigen negative units available in inventory, various blood centers in India were approached individually and through social media. Eleven R2R2 units were transferred by air from three blood centers from North India (New Delhi) to South India (Chennai) with the help of Courier services maintaining cold chain over 24 h with data logger facilities. The patient underwent LT with 2 units (R2R2 phenotype) transfused intraoperatively and 3 units in postoperative period. The patient was discharged on postoperative day 18 with Hb 8.0 gm/dL. The case highlights the need for national/zonal database of rare phenotype blood donors to timely fulfil the blood requirement of patients in need.
  Citation: Global Journal of Transfusion Medicine 2023 8(1):82-85
  PubDate: Fri,12 May 2023
  DOI: 10.4103/gjtm.gjtm_86_22
  Issue No: Vol. 8, No. 1 (2023)
Is indirect coombs test by pooled cells sufficient for antibody screening?
An eye-opening case series
- Authors: P Sriraman, Dibyajyoti Sahoo, Abhishekh Basavarajegowda, Shahida Noushad, Esha Toora, Rajendra G Kulkarni
  Pages: 86 - 88
  Abstract: P Sriraman, Dibyajyoti Sahoo, Abhishekh Basavarajegowda, Shahida Noushad, Esha Toora, Rajendra G Kulkarni
  Global Journal of Transfusion Medicine 2023 8(1):86-88
  The ideal way to screen for the presence of alloantibodies is by antibody screening panels which represent all clinically significant antigens in appropriate dosage. Most centers use pooled O-cells for antibody screening as it has antigens of non-ABO blood group systems that are prevalent in a representative population. Pooled O-cells sometimes fail to detect antibodies to less prevalent red blood cell antigens with reduced expression or show a dosage phenomenon. Despite pooling 4 to 5, O-donor segments, sometimes, it is difficult to detect clinically significant antibodies. False-negative indirect Coombs test by pooled O-cells may delay getting a compatible unit for elective cases where type and screen policy is used. Donor units with weak antigenic expression or units showing dosage can come compatible despite being antigen positive and lead to a hemolytic reaction. We report two cases where antibody screening by pooled O-cells was negative; still, cross-match was incompatible. Antibody screening with a three-cell panel was positive. Antibody identification with 11-cell panels confirmed the alloantibody to be anti-E. The present cases emphasize the importance of three-cell panels over pooled O-cells.
  Citation: Global Journal of Transfusion Medicine 2023 8(1):86-88
  PubDate: Fri,12 May 2023
  DOI: 10.4103/gjtm.gjtm_74_22
  Issue No: Vol. 8, No. 1 (2023)
Hypertriglyceridemia with pancreatitis, a complication of l-asparaginase
therapy in acute lymphoblastic leukemia, managed by therapeutic plasma
exchange
- Authors: Sourav Chowdhury, Sudipta Sekhar Das, Anupam Chakrapani, Aeshrat Banu
  Pages: 89 - 91
  Abstract: Sourav Chowdhury, Sudipta Sekhar Das, Anupam Chakrapani, Aeshrat Banu
  Global Journal of Transfusion Medicine 2023 8(1):89-91
  A confirmed case of 41-year-old male with T-cell precursor acute lymphoblastic leukemia was inducted to BFM 2002 protocol, induction phase 1 (this protocol includes injection daunorubicin, vincristine, L-asparaginase with triple intrathecal injection of methotrexate, cytosine, hydrocortisone, and oral prednisolone). The patient complained of epigastric pain with hepatosplenomegaly and laboratory investigation revealed deranged lipid profile with hypertriglyceridemia (HTG) as a major feature and hyperbilirubinemia and raised transaminase. He was diagnosed with a case of HTG with acute pancreatitis, a complication, due to L-asparaginase. Initially, his condition was treated with medical management, but reduction in triglyceride (TG) level was not as expected. It was decided then to manage the case with concomitant therapeutic plasma exchange therapy. One exchange not only reduced the TG level drastically but also the bilirubin level and the patient recovered and was able to start the next phase of the protocol.
  Citation: Global Journal of Transfusion Medicine 2023 8(1):89-91
  PubDate: Fri,12 May 2023
  DOI: 10.4103/gjtm.gjtm_91_22
  Issue No: Vol. 8, No. 1 (2023)
Undiagnosed dual blood disorder – Thalassemia with acute
myeloid leukemia
- Authors: Rekha Nirwan, Ketaki Prashant Mannur, Divya Singh
  Pages: 92 - 95
  Abstract: Rekha Nirwan, Ketaki Prashant Mannur, Divya Singh
  Global Journal of Transfusion Medicine 2023 8(1):92-95
  Thalassemia syndromes represent a group of inherited disorders characterized by decreased synthesis of one or more of the four globin chains in hemoglobin. The clinical spectrum ranges from asymptomatic carrier state to transfusion-dependent severe disease. The availability of better treatment options has increased the life expectancy in these patients and consequently paved the way to develop malignancies. Although many studies are published on the association of solid organ and lymphoid malignancies, only one case has been reported so far for acute myeloid leukemia (AML) coexisting with thalassemia syndromes. Herein, we report the first case of AML associated with beta-thalassemia in an adult Indian expatriate woman in Qatar. She presented with prolonged bleeding after a dental procedure. She was diagnosed as concurrent AML and beta-thalassemia trait on the laboratory evaluation. This case signifies the use of peripheral blood film evaluation for any abnormal hemograms in the modern era of automation. It also warrants caution for clinicians in suspecting malignancies in thalassemia although direct genetic linkage or associated risk is a matter of research.
  Citation: Global Journal of Transfusion Medicine 2023 8(1):92-95
  PubDate: Fri,12 May 2023
  DOI: 10.4103/gjtm.gjtm_102_21
  Issue No: Vol. 8, No. 1 (2023)
A rare case of Hb Q India- An uncommon hemoglobin variant
- Authors: Tejal Vishandas Ahuja, Nidhi Bhatnagar, Shital Soni, Mamta C Shah, Sangita D Shah
  Pages: 96 - 98
  Abstract: Tejal Vishandas Ahuja, Nidhi Bhatnagar, Shital Soni, Mamta C Shah, Sangita D Shah
  Global Journal of Transfusion Medicine 2023 8(1):96-98
  Hemoglobinopathies are the most common hereditary disorders in India and pose a major health problem. Both beta-thalassemia and structural hemoglobin (Hb) variants are relatively common in North-Western India. Here, we report a case of a 26-year-old female (caste-Lohana) who came to us for premarital screening hemoglobinopathy. A complete blood count was done on automated cell counter. Hb analysis was carried out using high-performance liquid chromatography (HPLC) Bio-Rad VARIANT II Hb Testing System. HPLC analysis showed a peak in the unknown window with retention time (RT): 4.72 min and area: 18.9% and S-window with RT: 4.33 min and area: 0.5%, which was suggestive of Hb Q India. Further workup was done on other family members also. And found that the mother and sister of the patient also had similar findings (Hb Q India) and the father of the patient was positive for beta-thalassemia trait. Hb Q India is a rare hemoglobinopathy, which presents in mostly heterozygous form. The inheritance of Hb Q India is autosomal dominant.
  Citation: Global Journal of Transfusion Medicine 2023 8(1):96-98
  PubDate: Fri,12 May 2023
  DOI: 10.4103/gjtm.gjtm_95_21
  Issue No: Vol. 8, No. 1 (2023)
Immunohematological discrepancy – Due to nuisance antibody!
- Authors: Ruhi Mehra, Abhay Bhave, Savita Pujare, Nitin Chavan
  Pages: 99 - 101
  Abstract: Ruhi Mehra, Abhay Bhave, Savita Pujare, Nitin Chavan
  Global Journal of Transfusion Medicine 2023 8(1):99-101
  Timely provision of blood plays an important role in the management algorithm of patients. Interference by minor blood group (BG) antibodies has become a common entity among multi-transfused patients; other nonsignificant antibodies are too encountered rarely. We report one such interfering nonspecific antibody in a 55-year-old female patient posted for splenectomy at our institute. BG discrepancy (type one) with a pan-positive (4+) antibody screening panel was found in her testing results. Crossmatches were compatible at antihuman globulin phase and at room temperature, and autocontrol was negative. Detailed meticulous immunohematological workup helped us in concluding that the offending antibody was not directed against the ingredients of column matrix of gel cards or the enhancement media (low ionic strength solution); rather it was directed against the chemical constituents in the suspension medium of commercial cell panel. Bearing the presence of nonspecific “nuisance” antibodies in mind becomes extremely important so that they can be detected and managed quickly.
  Citation: Global Journal of Transfusion Medicine 2023 8(1):99-101
  PubDate: Fri,12 May 2023
  DOI: 10.4103/gjtm.gjtm_72_22
  Issue No: Vol. 8, No. 1 (2023)
Dramatic response to therapeutic plasma exchange in acute transverse
myelitis following dengue fever: A case report
- Authors: Pandeep Kaur, Rakesh Kumar, Mohitpreet Singh, Prabhjeet Singh
  Pages: 102 - 104
  Abstract: Pandeep Kaur, Rakesh Kumar, Mohitpreet Singh, Prabhjeet Singh
  Global Journal of Transfusion Medicine 2023 8(1):102-104
  Dengue is a mosquito-borne viral disease which has reached fearsome proportions in the past few years. Acute transverse myelitis (ATM) is a rare complication of dengue characterized by onset of bilateral lower limb weakness, paresthesia, and urinary retention and magnetic resonance imaging of the whole spine shows diffuse areas of abnormal hyperintensity on T2-weighted images involving the cord in the cervical and the dorsal region extending up to the level of conus. Treatment is usually steroids, intravenous immunoglobulin, and therapeutic plasma exchange (TPE). We report a case of ATM in a young male patient who was successfully treated by TPE.
  Citation: Global Journal of Transfusion Medicine 2023 8(1):102-104
  PubDate: Fri,12 May 2023
  DOI: 10.4103/gjtm.gjtm_67_22
  Issue No: Vol. 8, No. 1 (2023)
Selective leukoreduction is all that we need in low- and middle-income
countries
- Authors: Kalyan Broto Roy
  Pages: 105 - 105
  Abstract: Kalyan Broto Roy
  Global Journal of Transfusion Medicine 2023 8(1):105-105
  
  Citation: Global Journal of Transfusion Medicine 2023 8(1):105-105
  PubDate: Fri,12 May 2023
  DOI: 10.4103/gjtm.gjtm_93_22
  Issue No: Vol. 8, No. 1 (2023)
Universal leukoreduction-Need of the hour
- Authors: Keerthi Chinthapeta
  Pages: 106 - 106
  Abstract: Keerthi Chinthapeta
  Global Journal of Transfusion Medicine 2023 8(1):106-106
  
  Citation: Global Journal of Transfusion Medicine 2023 8(1):106-106
  PubDate: Fri,12 May 2023
  DOI: 10.4103/gjtm.gjtm_76_22
  Issue No: Vol. 8, No. 1 (2023)
A sole emphasis on the increase in whole blood donations. Is it advisable
in Iran?
- Authors: Mahmoud Hadipour Dehshal, Ali Akbar Pourfathollah, Karim Shamsasenjan
  Pages: 107 - 107
  Abstract: Mahmoud Hadipour Dehshal, Ali Akbar Pourfathollah, Karim Shamsasenjan
  Global Journal of Transfusion Medicine 2023 8(1):107-107
  
  Citation: Global Journal of Transfusion Medicine 2023 8(1):107-107
  PubDate: Fri,12 May 2023
  DOI: 10.4103/gjtm.gjtm_64_22
  Issue No: Vol. 8, No. 1 (2023)
Postdonation information and blood component withdrawal (recall): Need for
national guidance
- Authors: Deepti Sachan, T Varnish, Deepthi Krishna Gundrajukuppam
  Pages: 108 - 108
  Abstract: Deepti Sachan, T Varnish, Deepthi Krishna Gundrajukuppam
  Global Journal of Transfusion Medicine 2023 8(1):108-108
  
  Citation: Global Journal of Transfusion Medicine 2023 8(1):108-108
  PubDate: Fri,12 May 2023
  DOI: 10.4103/gjtm.gjtm_87_22
  Issue No: Vol. 8, No. 1 (2023)

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